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January 1957

Operative Injury to the Accessory Nerve in the Posterior Cervical Triangle: Comment upon the Abduction Test for Trapezius Muscle Paralysis

Author Affiliations

Durham, N. C.
From the Neurosurgical Division, the Duke Hospital and Duke University School of Medicine.

AMA Arch Surg. 1957;74(1):122-127. doi:10.1001/archsurg.1957.01280070126015

The superficial course of the accessory nerve in the posterior cervical triangle makes it peculiarly susceptible to injury during lymph node biopsy, removal of minor tumor masses, and similar operative procedures in this portion of the cervical axis. Paralysis of the trapezius muscle causes loss of true abduction of the arm above 80 to 90 degrees and diffuse shoulder girdle discomfort. The accessory nerve may be damaged by actual section or compression by ligature. Because of its inherent ability to show adequate functional regeneration, somewhat similar to that exhibited by other relatively pure motor nerves, such as the radial and facial nerves, suture or relief of the compression force at the point of nerve damage is strongly indicated in these injuries.

Clinical Example  A 15-year-old boy developed fever, malaise, and generalized adenopathy, three months before ad

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